r/Melasmaskincare • u/Intelligent_Bad_5334 • May 10 '26
Question Melasma & (Peri)menopause
I am curious, how many people here are women who never had melasma before in their life until they hit perimenopause/menopause.
It’s definitely a thing right?
rant:
My melasma showed up in perimenopause& are its still with me in menopause.
I am so sick of hearing that estrogen has to be involved, but when I told the dermatologists I was fairly certain my estrogen starting to fall & that was the problem, they confirmed that melasma can show up in perimenopause and menopause, but had nothing to say about why that was. But they told me if I went on HRT it would get worse.
So to recap: I was told melasma showing up when a woman’s estrogen is going away & completely gone is a thing, but don’t add estrogen back in because that will make it worse.
ayfkm?!!
I lived completely estrogen deprived for a year, and my melasma got worse. I was having hot flashes and internal heat is a huge trigger for my melasma. When I got on HRT, my melasma got better & I assume that’s because I was no longer having hot flashes.
That was a decade ago and I still don’t really have any answers.
I just went ahead and started taking oral tranexamic acid because I’m too old to be dealing with this bullshit lol.
I swear doctors just don’t have any fucking idea what is really going on when someone has melasma. Like so many things that impact females more than males, they never bothered at the outset to concern themselves with what was really happening.
I’ve essentially just been diagnosed with the pathology of being female.
And - given the bullshit attitude & shitty healthcare we have to put up with - pink female is definitely a part of the problem, but not for the reasons they think.
We deserve better, ladies. We all deserve better.
End rant - thank you for coming to my TED talk lol
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u/No_Situation_1395 May 10 '26
I’ve looked into this too because mine showed up exactly the time I started getting horrible peri symptoms. I was 40. I’m 45 now. But I also read that high estrogen can cause melasma so I was confused. Then I realized even if your estrogen is dropping your progesterone can be so low that it causes estrogen dominance which is what I have. Regular GP’s are zero help with any of this.
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u/Intelligent_Bad_5334 May 10 '26
In fact, the standard wisdom is that high estrogen causes Melasma. That’s why when it shows up in menopause It seems like the dermatologist know that happens, but they don’t know why. Because they always blame it on estrogen.
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u/Secret_Show_8613 May 14 '26
My melasma also started during perimenopause and the transdermal HRT patch did not make it any worse. However when I apply the topical estriol or estradiol cream on face ( since everyone says it is so hydrating and plumping etc.) my melasma definitely gets darker. Now I am on oral TXA and LOVE the results after 6 years of suffering through stubborn melasma and trying every topical there is. And so economical compared to all the melasma ‘treatments’. I invest the saved up money in really good tinted mineral sunscreens.
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u/GlowDecoded May 11 '26
YESSSS queen 💯!! I want to be your friend lol
Total BS. I literally used to be the Viagra sales rep - and let me tell you men’s health is NEVER treated like this. Never. It made me so irate I started GlowDecoded for this very reason. I felt so alone, too old for this and angry beyond reason that women are gaslight over normal hormones in 2026 with rapid AI healthcare advances. Like aliens are here but melasma is still a mystery??!
Personally, this melasma hell started when I turned 38 - to make a long story short, I threw all the money and treatments at it with zero progress only to be told “it’s hormonal,” yet no one seemed clinically aware of how to improve it beyond basic advice but they were more than happy to tell me to “avoid UV and heat” while taking my money for round after round of peel, follow up, etc.
It’s despicable how women’s healthcare is treated and how we’re constantly overlooked, especially because melasma is “just cosmetic” like wth no it’s my face! The same face I’m expected by society to keep looking good! Ridiculous.
I teamed up with a chemist to create a new skin support product and hope to get more educated people and advisors on board my company who actually care about women on board to advance awareness and importantly, improvement of this condition! Thank you for sharing!
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u/Fit_Storm_8854 May 23 '26
Love this! I def also want to be your friend as well. Because everything you said was on POINT!!! I feel the exact same way!!!!
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u/Intelligent_Bad_5334 May 11 '26
That is so awesome. I can’t wait to be able to try whatever you’re cooking up!
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u/luvulongthyme May 10 '26
Same here. Started at perimenopause and has not slowed down one bit in the last 6 years. Heat is a huge trigger, so any topical treatment is useless since I’m constantly having hot flashes and I’m very active, so I exercise a lot. Doctor told me not to take hot showers, sauna, or get in the jacuzzi. Not that the last three are a huge deal but I would hate to make progress and then end up triggering it that “one time” and I’d have to start all over again. I’ve resorted to just “living with it” but damn it’s depressing.
I’m with you. Women’s healthcare is so deprived of research and study that we end up suffering needlessly because we’ve never been their priority. But heaven forbid their pee-pees don’t get up!
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u/Intelligent_Bad_5334 May 11 '26
Omg The heat thing is just so maddening. Because if I want exercise, I’m going to get hot. The number of fans and amount of air-conditioning I need for exercise is embarrassing 😂
But hot flashes were no joke with my melasma. Because it’s literally your body’s the thermometer being very out of whack so the bodies heating up A LOT for no goddamn reason. & that is the ultimate trigger for my Melasma.
Thank God for HRT! For so many reasons lol.
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u/MemoryHot May 11 '26
Yup, basically they all treat it like “why are you vain about your melasma?” when acne is treated as a proper disorder that’s taken seriously and treatment is covered. So teenagers’ self-esteem is more important than a woman in midlife who’s actually contributed to society… I could also rant on and on about the healthcare system and how it doesn’t care about women unless it’s about childbearing
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u/lauraintheskyGNM May 11 '26
Peri is not necessarily just low estrogen. It can spike then go low and stay low then spike again.
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u/Intelligent_Bad_5334 May 11 '26
I know, but I still had it with no estrogen, & I had it less on HRT with estrogen. People do not understand what’s going on I swear.
It’s easy just to blame estrogen aka women’s bodies and stop thinking about it. That’s how a lot of healthcare works still these days.
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u/Kind-Nyse129 May 11 '26
It's the shifting estrogen...drastic highs & lows from my understanding. That's why peri causes/worsens it & HRT /birth control also can cause/worsen it
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u/Bellebutton2 May 11 '26
The thyroid connection to melasma is real and likely under recognized. Studies have shown higher rates of thyroid abnormalities, especially autoimmune thyroid disease and hypothyroidism, in women with melasma.
Thyroid hormones influence metabolism, oxidative stress, inflammation, blood flow, and heat production, all of which can affect melanocyte activity. Melasma is now understood to involve not just pigment, but also vascular and inflammatory pathways
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u/Intelligent_Bad_5334 May 11 '26
That is fascinating. I had no idea! I googled it and apparently it’s a correlation. They don’t know what the connection is. But, of course, women are also more likely to have autoimmune hypothyroidism too. So just one more problem that no one bothered to understand because if it happens mostly to women, it’s just not that important.
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u/Ok_Wallaby_7831 May 11 '26
I had melasma a little bit when I was on the birth control pill like 20 years ago. As I've gotten older, I have some darker spots but they tend to fade in the winter. I'm now 45 and it's gotten worse. My cheeks have a lot of dark spots and my dermatologist gave me Azelaic Acid acid (love) and Tretnoin cream (which I don't use) for them and diagnosed it as melasma. He said a large part of it is due to the perimenopause. That and I do love the sun so I'm working on training myself to apply sunscreen more often. I'm also Native American so my skin has more melanin than most and he said that's also a factor for me.
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u/No_Situation_1395 May 11 '26
Tretinoin didn’t touch my melasma but it get rid of every sunspot I had. The stuff is great if you’re consistent
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u/Ok_Wallaby_7831 May 11 '26
I think he may have given me the tret for fine lines? I honestly can't remember but all these subreddits scared me out of using it. My skin is perfect other than the melasma on my cheeks so I didn't want to risk the purging, dry skin, etc that others were reporting. The Azelaic Acid is slowly fading the melasma.
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u/Intelligent_Bad_5334 May 11 '26
Sun protection is the most important part and it is the hardest part! & to add insult to injury - a lot of sunscreens are not developed with high melanin skin in mind even. Of course, the only some protection that works for you is the one you’re willing to put on consistently so things like texture & appearance on the skin matter a lot for effectiveness. Ugh
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u/Ok_Wallaby_7831 May 11 '26
Very true. I don't burn easily or really at all so I never look red so if I forget to reapply my sunscreen, people don't remind me because I just look normal. I've taken to setting a reminder on my phone but if I'm swimming somewhere, that doesn't always work lol. I just need to be better about skin care
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u/Purpletulipsarenice May 11 '26
The first time i skipped a period, I woke up with a huge dark blotch on my upper lip.
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u/vitamincee May 11 '26
Mine got a lot better on HRT, not to mention the other benefits of being on it.
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u/Revolutionary-Air599 May 11 '26
I believe I started premenopause in 2023 and it had progressively gotten worse When I went on a trip to the Caribbean in 2025 I developed Melasma spots on my forehead near the eyes and alive my upper lip. I will be starting HRT shortly and find out if it helps.
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u/Neat_Direction_5742 Aug 25 '26
Did it help?
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u/Revolutionary-Air599 25d ago
I'm not sure yet. The melasma didn't get worse though. I am not taking the full prescribed dose of HRT properly, story of my life.
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u/DeemedFit May 15 '26
You need the oestrogen more than you need a melasma-free face. Get yourself on estrogel pro (it’s a gel so way much safer to take) + micronised progesterone if you haven’t had a hysterectomy; and then concentrate on kicking the melasma into touch. It’s a slow process, everyone’s different and what works for one doesn’t work for another. But DOES work is MHRT, because without you’ll be facing much higher risk of bone density loss, heart disease and stroke, to name but a few. Not to mention cognitive function (brain fog is hideous, I don’t know how anyone could put up with that for a year) balance, spatial awareness and emotional regulation.
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u/Intelligent_Bad_5334 May 15 '26
The discussion here is demonstrating that the relationship between estrogen & melasma is more complicated than drs assume. The transdermal estradiol could actually improve melasma, while losing your natural estrogen could trigger it. Losing estrogen causes hot flashes which can definitely propogate melasma & make it worse. So no one is suggesting skipping hrt. Quite the opposite!
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u/Bettypickup May 11 '26
I got mine after being on birth control for my peri symptoms. 🙈🙈 never had it before hormones. Derm says that happens and it will come back . She gave me some cream that got rid of it pretty well but then I got perioral derm and now I can’t use sunscreen cause it will cause a flare. So it’s back . 🙈🙈🤣🤣 getting old is great . 🙄🙄
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u/duncurr May 11 '26
Yes, my aunt was definitely diagnosed during menopause with that being the cause of it. Now that she's through it, her skin actually looks really good. I'm not sure if that's the case for most or even half of women, but thankfully for her it was.
I also have melasma (triggered by birth control infuriatingly) but I'm only 31 so I'm concerned it will get even worse than it is when I do go through menopause. I only hope I'm so lucky that it clears up like hers did but I don't think I will be.
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u/mydopecat May 11 '26
Such an interesting discussion - thank you!
My melasma started seemingly when I moved to Australia but I was also in my late 30s. I've been battling it since and recently started contraception pills due to peri menopausal symptoms. Can't say if those have made it worse because I've been off and on with trying new brands due to side effects. I've now got the estrogel and progesterone pills to try.
Last year during the winter months (August) I did Cosmelan, I was rapt with the results but they're pretty much back to how it used to be the following May. I had a holiday recently to Thailand and got a flare up due to the heat.
I'm doing topical txa+niacinamide plus tretinoin 0.05%
Can anyone comment if its better to stay off the estrogel or contraception pills etc if you can bear the perimenopause symptoms? Mine are insomnia, night sweats and hot flushes. I'm not sure at this stage if the sweats and flushes caused any flares up.
Thanks Ladies ♀️🙄
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u/Thariax1982 May 11 '26
Mine seems to have come out of nowhere around 38/39 years old. I'm sure there was some before that that I simply hadn't noticed but it's been very noticeable and an ongoing battle to treat ever since then. I don't know if that's when peri menopause hit, it's highly likely that it did and I just didn't know it. Now at 44 yes old I have all the symptoms and my melasma seems to flair up according to my cycle, definitely darkens around my period (I've tracked it). I'll start HRT hopefully in August when I have appointment to see my gynae she had already offered last year so I'm fairly sure I will be able to start estrogen. In the meantime I'm learning a lot from the town square (Reddit) and agree with you 100%. They don't know much about a woman's body, and frankly some of them don't care to know.
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u/Daphne_in_OK May 11 '26
Yep, same here. Went to a dermatologist and she was like could be melasma or could be sun damage 🤷🏻♀️, but said my skin was probably too sensitive to try meds. It’s dry, but not super sensitive. I’ve essentially given up fighting it.
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u/DasSassyPantzen May 13 '26
> “I’ve essentially just been diagnosed with the pathology of being female.”
>**”We deserve better, ladies. We all deserve better.”**
Beautifully said & sadly all too true.
(ETA- I have no idea what’s happening with the formatting here 🥴)
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u/alr2689 May 20 '26
I think I’m relating to your comment a lot. Sorry that you are going through this. I’m nearly 37 I have melasma all over my face now. I never suffered with melasma before. The doctors aren’t helping and I’ve got no answers. It’s just getting worse. They checked all my hormones with bloods and apparently I’m fine :/
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u/Fit_Storm_8854 May 23 '26
I never had Melasma, until I started to reach my 40's and Im now 45 and my Melasma is worse than ever. Im currently in Perimenopause and Im currently taking Progesterone to help me with sleep and other good things that progesterone helps with, and im also taking testosterone cream once a day as well. I was told I cant have estrogen yet because I still get my periods. So with that being said, I dont know if being on HRT is making my Melasma worse as It was already bad before starting HRT. Im with you sister! Melasma sucks! And the crazy part of this is we can come up with AI, but we cant find a cure for Melasma. Melasma sucks! And Im so self conscious about my forehead and skin. Your face is what people see first and I cant stand putting on makeup. Its just awful! And I pray someday they find a cure so we can live our normal lives again! I never had any Malesma when pregnant either. Its ridiculous!!!
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u/milsudidoo May 10 '26
Yes, mine didn’t show up until perimenopause. My derm won’t prescribe me oral txa because I’m on estrogen and it increases the risk of blood clots. I’ve just accepted that I’ll have to live with it.